Many people in deprived areas distrust dentists and are deterred from buying toothpaste and toothbrushes because of the cost, according to an Edinburgh University survey.
The report from Edinburgh's centre for dental education comes as the Scottish Office has pledged a Pounds 250,000 campaign for innovative projects to improve dental health. Scotland has one of the worst dental health records in Europe.
Edinburgh's survey of 11 groups of adults in Wester Hailes, one of the city's poorest areas, found that their oral health beliefs and practices were largely unchanged from a similar survey in 1982.
While the adults agreed that healthy teeth were important, especially in children, many felt they could not afford to visit the dentist because of the perceived cost.
"There is little awareness of the existence of free dental treatment for those receiving family credit or income support, and young people under 18," said Philip Sutcliffe, director of the centre.
Brushing teeth with a fluoride toothpaste fought against the twin attacks of tooth decay and gum disease, Professor Sutcliffe said. But in the survey, it was widely suggested that the main function of brushing was to freshen the mouth and breath, and remove stains caused by smoking.
While dentists promoted fluoride because of its therapeutic value, the survey showed that people dismissed the use of fluoride and the availability of mouthwashes as gimmicks to sell more products.
"Dentists were not trusted and were suspected of overprescribing and overtreating patients," he said. But Professor Sutcliffe said that among the general population, there had been a vast improvement in children's dental health, and the number of people who lost all their teeth was dropping rapidly.